PROVINCE OF BUKIDNON Municipality of San Fernando MUNICIPAL SOCIAL WELFARE & DEVELOPMENT OFFICE SOLO PARENT PURCHASE BOOKLET FOR INQUIRIES AND/OR COMPLAINTS Contact: Solo Parents Division Municipality of San Fernando Municipal Social Welfare and Development Office Purok 6, Halapitan 09053280688 mswdo@lgusanfernandobuk.gov.ph 10% Discount for all Item Code ROGELIO C. YEKE Municipal Mayor
PURCHASE BOOKLET Name of Province / City / Municipality Full Name of Solo Parent 1x1 picture Category SPIC Number Address (No, Street, Barangay, City, Province, Region) Date of Birth Place of Birth Name of Dependent (child number) Sex Date of Birth Relationship to SP 1. 2. 3. * For dependents 6 years old and below only. Use notes page for additional children Date of Validity Issued by Approved by (MM/DD/YY to MM/DD/YY) (C/MSWDO: Name and Signature) (Mayor: Name and Signature) * Booklet must be presented with valid Solo Parent Identification Card (SPIC) Signature of Solo Parent (thumbmark for non-literate person)
S – Food and micronutrient Supplements, PM – Prescribed Medicine, PV – Prescribed Vaccine, PMS – Prescribed Medical Supplement Child Number Date of Purchase (MM/DD/YY) Item Code QTY (pcs/kg/g) Signature of attending staff ITEM CODE: M – Baby’s Milk, D – Sanitary Diaper, S – Food and micronutrient Supplements, PM – Prescribed Medicine, PV – Prescribed Vaccine, PMS – Prescribed Medical Supplement Child Number Date of Purchase (MM/DD/YY) Item Code QTY (pcs/kg/g) Signature of attending staff
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